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The Truth About Cancer
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Watching: The Truth About Cancer

Chapter 4: The Three Oldest Methods [10:46]

Jamie discusses her prognosis with family. Linda recalls Larry's three options: surgery, radiation and chemotherapy.

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Transcript: Chapter 4 - The Three Oldest Methods

ABBYE WARREN: No, I know, but even the first time, we were upstairs in the room...

JAMIE KLAYMAN: So did you hear: Dad, he's had someone call for um, a second opinion for Boston. Because I don't think there's anything in Providence that we unfortunately haven't already heard about. I don't know that there's any secret -- secret answer.

NORMAN KLAYMAN: There's two of them.

JAMIE KLAYMAN: Oh, see?

ELAINE ROBINSON: I think that she...

NORMAN KLAYMAN: There's the two.

ABBYE WARREN: Just ask Dad.

JAMIE KLAYMAN: I don't -- oh, this is from Texas. Yeah, so this is the guy in Texas I'll check out.

NORMAN KLAYMAN: That's at the University of, uh, Texas.

JAMIE KLAYMAN: You know, I mean -- I don't -- I think it'd be great to think that -- that there's an easy answer somewhere...

EDDIE KLAYMAN: Isn't it worth making a phone call?

JAMIE KLAYMAN: ...but I don't know that -- you're gonna hear what you want to hear some place else, just for the sake of it; unfortunately, I don't know that it works that way.

NORMAN KLAYMAN: There are -- there are people that have different points of view on these things, and I think that the -- some of these institutions know what they're doing, too.

JAMIE KLAYMAN: My dad is kind of thinking, you know, get a second opinion; that there's got to be somebody somewhere, whether it's in Texas, or California, or Rhode Island.

*

JAMIE KLAYMAN: [dialing] Yeah, hi Helen, um, my name is Jamie Klayman. I'm a - I'm, I'm a new patient, but I'm interested in making an appointment to see Doctor Howard Safran. Um, I am - ah, have metastasized pancreatic cancer...

JAMIE KLAYMAN: You know, and I started explaining to him that I don't think there's anyone hiding the secret magic beans that are gonna cure people, and you only get that secret magic cure if you're in California, or if you're in Texas, or you just happen to move a block over...

JAMIE KLAYMAN: You know, my family was intere... interested in me getting a second opinion, and my oncologist had recommended Dr. Safran.

*

NORMAN KLAYMAN: There are a lot of people that have good ideas that nobody listens to...

JAMIE KLAYMAN: I think, I think a lot of people have good ideas, so I mean I, you know, I'll check out anywhere. I'll check out some places...

EDDIE KLAYMAN: You know, you know what they did...

JAMIE KLAYMAN: I have no problem doing some traveling to go maybe look at some things.

ELAINE ROBINSON: What kind of ideas, Norman?

NORMAN KLAYMAN: A different approach, like I saw on TV -- I can't remember who it was...

JAMIE KLAYMAN: It's really hard for my dad.

NORMAN KLAYMAN: ...pancreatic cancer, and they said, they were using...

JAMIE KLAYMAN: He feels as though we didn't do everything that we could with my mom.

NORMAN KLAYMAN: ...they never -- they never even mentioned it.

ELAINE ROBINSON: They never...

JAMIE KLAYMAN: We did lose my mom about five years ago. Unfortunately, she had lung cancer. You know, it was hard for him to lose her. I mean, they were really close, and I think he's definitely bringing that baggage with him a little bit, which is hard to think that there was something else that we could have done, um, that we didn't do, and I think that he's kind of thinking that that's happening all over again.

*

CHRIS FLETCHER: And this looks like it's got atypical hypochromatic nuclei in it. I've got a hint of...

NARRATOR: A pathologist ends his day as he began it--determining whether new patients have cancer. During the night-shift, he looks at slices of tumors, sent from colleagues all around the world.

TRAVIS HOLLMANN: This is a 21-year-old guy with a left hand lesion.

CHRIS FLETCHER: So here's the lesion on the hand of the 21-year-old, and this is very typical. So they did the very trendy thing of doing a sentinel lymph node biopsy; they're on there looking if the tumor spread, because if it has, then they would take out all the lymph nodes in the axilla.... I don't think this is metastatic tumor. I don't think they'll need to do any more. But you could understand why they would suspect that. Right, I think this will be positive, meaning, not cancer...

NARRATOR: Tomorrow, a little boy in Haifa, Israel will get good news. A 44-year-old woman from Nashville will get devastating news. Somewhere in the world, a 26-year-old man will feel lucky; and elsewhere, a 48-year-old will learn that he will likely die within a year. Their journeys have now begun.

*

LARRY D'ONOFRIO: [sigh] And that's why, you know. The one at Mass General was easier because it just simply turned that decision over to somebody. This one is--and I think the ac - the point...

NARRATOR: Years earlier, Larry had begun his own journey. Two days away from a surgical procedure that was so risky, many surgeons refuse to attempt it, he was filling out a health care proxy.

LINDA GARMON: ...I would want...

LARRY D'ONOFRIO: I don't want to be in a situation where I don't recognize people.

NARRATOR: Like pancreatic cancer, Larry's cancer is often diagnosed after it has already spread, and we had read plenty of grim statistics about mesothelioma.

LARRY D'ONOFRIO: I think organ donation is not worth get--you know, there's no point, because who's going to take cancerous organs. So, yeah, give me antibiotics...

NARRATOR: But when a loved one has only a long shot of surviving, you focus on the fact that he still has a shot. If the chances are 1 in 10, you believe he will be the 1. So on this night, it was impossible to feel any fear.

*

KATHLEEN LALLY: When was the last time you had anything to eat or drink?

LARRY D'ONOFRIO: Uh, it was last night, before midnight.

KATHLEEN LALLY: Any dentures?

LARRY D'ONOFRIO: No.

KATHLEEN LALLY: Contact lenses? Jewelry?

LARRY D'ONOFRIO: No.

NARRATOR: On the morning of Larry's surgery, we prepared ourselves for the possibility that we'd hear the four words cancer patients fear the most: the cancer is inoperable.

LARRY D'ONOFRIO: Now I'm horizontal. I never have to be vertical again. A few little needles, a few pin-pricks, and...and the next time I see you, I'll be...

LINDA GARMON: ...crying for morphine.

LARRY D'ONOFRIO: ...close to death.

LINDA GARMON: Ugh.

NARRATOR: Until the surgeon opened Larry up, we would not know whether his cancer had already spread from his lung to his heart, a common path for mesothelioma. In that case, the surgeon would quickly close Larry, and his prognosis would be dire. He'd likely have only months to live.

LARRY D'ONOFRIO: Bring a little bit of snow and just put it on my face. No, no yellow snow.

LINDA GARMON: [laughs]

LARRY D'ONOFRIO: So now we say goodbye?

MAURICIO NINO: Yeah.

LINDA GARMON: Is this goodbye for the whole day?

MAURICIO NINO: Uh...you can come to the recovery room.

LINDA GARMON: Oh, no, I mean, so I won't see him before surgery?

MAURICIO NINO: No.

LARRY D'ONOFRIO: Bye.

LINDA GARMON: Oh, well. Will you give us a minute?

MAURICIO NINO: We will start working now and we will go to the operating room as soon as we are done here.

LARRY D'ONOFRIO: Goodbye.

LINDA GARMON: I'll feel a lot better when the doctor comes and says he took the cancer out, or took the bulk of the cancer out. I just - right now, I'm like completely nervous that... I, I've had this bad scenario playing in my mind; this bad vision over the last couple of days that the doctor will come out much earlier than the length of the procedure, like 30 minutes after he starts, and I'll see him walk out and I'll tense up and I'll know that means the cancer's already spread and he couldn't do anything or something...ugh.

LINDA GARMON: No, but Mom, this is really a good sign because the surgery started at 7:30 and it's almost 9 o'clock. It's now - oh my god, it's now ten-'til-ten.

NARRATOR: On the day of Larry's surgery, with every minute that passed, I was energized with growing confidence that his cancer was being removed in the operating room.

LINDA GARMON: Okay Kate, I'll talk to you. We just checked and...

NARRATOR: Indeed, four hours after the procedure began, the surgeon brought good news to Larry's family and me, and for the first time since his diagnosis, we were reassured.

*

NARRATOR: This was to be the start of a six month ordeal involving the three oldest cancer treatments. Surgery would take out the bulk of Larry's cancer; chemo and radiation would blast any stray rogue cells. To Larry and me, the radiation room looked like a set from a 1950s science-fiction movie. And the chemo ward looked like a war zone; an apt analogy, I later learned, because some chemos are based on mustard gas, used as a weapon in World War I. As it happened, the first real turning point in using chemo to treat cancer occurred in children.

DAVID NATHAN: And I remember a friend of mine dying of leukemia when I was a child; and the kid had leukemia and he was gone in months.

DAVID NATHAN: ...and these devastated parents, you know, and...

DAVID NATHAN: The history of, of childhood leukemia, which is really the history of the treatment of, of cancer today, uh, is a fascinating one. My early days at the National Cancer Institute, in pediatrics, can only be described as a nightmare. The drugs were very toxic, so the children were vomiting blood, and had, uh, diarrhea of blood, and, and finally bled into their eyes, and, and then thankfully, into their brains, and they would die and be released from this. We didn't know the doses at that time. We didn't know the frequency by which the drugs should be given, but by 1960, 3 out of 17 children had gone into a complete remission. I mean, childhood leukemia is virtually curable today.

DAVID NATHAN: It's just the difference now in leukemia is that I was sort of crying because I didn't have any survivors, and you're gonna cry when you lose one. You're at eighty-five percent.

DAVID NATHAN: I mean, it's incredible turnaround. Now, is it toxic? Yes, it is; there's still damage to some of these children, and some of it is serious.

GEORGE DEMETRI: Why do these poisons help people? How could they possibly help a patient with cancer? And the answer is, they can kill dividing cells, cells that are making copies of themselves. Cancer cells make copies of themselves, but so do some normal cells. The follicles of the hair cells are actually dividing, so if you knock them with chemotherapy, they'll be damaged and the hair will fall out. So if you treat a patient with cancer with chemotherapy, aiming to hit the cancer, inadvertently, you'll get friendly fire.

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